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Sarah T Pendlebury - One of the best experts on this subject based on the ideXlab platform.
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test accuracy of the Montreal Cognitive Assessment in screening for early poststroke neuroCognitive disorder the nor coast study
Stroke, 2021Co-Authors: Sarah T Pendlebury, Ragnhild Munthekaas, Stina Aam, Ingvild Saltvedt, Torgeir Bruun Wyller, Stian Lydersen, Hege IhlehansenAbstract:Background and Purpose: We determined the diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) for poststroke neuroCognitive disorder defined according to the Diagnostic and Statistical ...
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routine Cognitive screening in older patients admitted to acute medicine abbreviated mental test score amts and subjective memory complaint versus Montreal Cognitive Assessment and iqcode
Age and Ageing, 2015Co-Authors: Sarah T Pendlebury, S Klaus, M Mather, M De Brito, R WhartonAbstract:Introduction: routine Cognitive screening for in-patients aged ≥75 years is recommended, but there is uncertainty around how this should be operationalised. We therefore determined the feasibility and reliability of the Abbreviated mental test score (AMTS/10) and its relationship to subjective memory complaint, Montreal Cognitive Assessment (MoCA/30) and informant report in unselected older admissions. Methods: consecutive acute general medicine patients aged ≥75 years admitted over 10 weeks (March–May 2013) had AMTS and a question regarding subjective memory complaint (if no known dementia/delirium). At ≥72 h, the 30-point Montreal Cognitive Assessment (MoCA) and Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE) were done. Cognitive impairment was defined as AMTS < 9 or MoCA < 26 (mild impairment) and MoCA < 20 (moderate/severe impairment) or IQCODE ≥ 3.6. Results: among 264 patients (mean age/SD = 84.3/5.6 years, 117 (44%) male), 228 (86%) were testable with AMTS. 49/50 (98%) testable patients with dementia/delirium had low AMTS compared with 79/199 (44%) of those without (P < 0.001). Subjective memory complaint agreed poorly with objective Cognitive deficit (39% denying a memory problem had AMTS < 9 (kappa = 0.134, P = 0.086)) as did informant report (kappa = 0.18, P = 0.15). In contrast, correlation between AMTS and MoCA was strong (R2 = 0.59, P < 0.001) with good agreement between AMTS < 9 and MoCA < 20 (kappa = 0.50, P < 0.01), although 85% of patients with normal AMTS had MoCA < 26. Conclusions: the AMTS was feasible and valid in older acute medicine patients agreeing well with the MoCA albeit with a ceiling effect. Objective Cognitive deficits were prevalent in patients without known dementia or delirium but were not reliably identified by subjective Cognitive complaint or informant report.
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validation of the Montreal Cognitive Assessment versus mini mental state examination against hypertension and hypertensive arteriopathy after transient ischemic attack or minor stroke
Stroke, 2014Co-Authors: Alastair J S Webb, Sarah T Pendlebury, Z Mehta, Michela Simoni, Nicola Lovett, Peter M RothwellAbstract:Background and Purpose—Lack of reduced Cognitive impairment with blood pressure (BP) lowering in trials may reflect use of the Mini-Mental State Examination (MMSE), which is insensitive to mild Cognitive impairment after cerebrovascular events compared with the Montreal Cognitive Assessment. We determined relationships between impairment on MMSE versus Montreal Cognitive Assessment (MoCA) with the major physiological determinant of vascular Cognitive impairment: hypertension and hypertensive arteriopathy. Methods—Cognitive impairment in consecutive patients 6 months after transient ischemic attack or minor stroke was defined as significant, mild, or none (MMSE<23, 23–26, ≥27; MoCA<20, 20–24, ≥25) and related to 20 premorbid systolic BP readings, home BP measurement (3 measurements, 3×daily for 1 month), and hypertensive arteriopathy (creatinine, stroke versus transient ischemic attack, leukoaraiosis) by ordinal regression. Results—Of 463 patients, 45% versus 28% had at least mild Cognitive impairment on t...
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telephone Assessment of cognition after transient ischemic attack and stroke modified telephone interview of Cognitive status and telephone Montreal Cognitive Assessment versus face to face Montreal Cognitive Assessment and neuropsychological battery
Stroke, 2013Co-Authors: Sarah T Pendlebury, Sarah J V Welch, Jose Mariz, Z Mehta, Fiona C Cuthbertson, Peter M RothwellAbstract:Background and Purpose—Face-to-face Cognitive testing is not always possible in large studies. Therefore, we assessed the telephone Montreal Cognitive Assessment (T-MoCA: MoCA items not requiring pencil and paper or visual stimulus) and the modified Telephone Interview of Cognitive Status (TICSm) against face-to-face Cognitive tests in patients with transient ischemic attack (TIA) or stroke. Methods—In a population-based study, consecutive community-dwelling patients underwent the MoCA and neuropsychological battery >1 year after TIA or stroke, followed by T-MoCA (22 points) and TICSm (39 points) at least 1 month later. Mild Cognitive impairment (MCI) was diagnosed using modified Petersen criteria and the area under the receiver-operating characteristic curve (AUC) determined for T-MoCA and TICSm. Results—Ninety-one nondemented subjects completed neuropsychological testing (mean±SD age, 72.9±11.6 years; 54 males; stroke 49%) and 73 had telephone follow-up. MoCA subtest scores for repetition, abstraction, ...
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telephone Assessment of cognition after transient ischemic attack and stroke modified telephone interview of Cognitive status and telephone Montreal Cognitive Assessment versus face to face Montreal Cognitive Assessment and neuropsychological battery
Stroke, 2013Co-Authors: Sarah T Pendlebury, Sarah J V Welch, Jose Mariz, Z Mehta, Fiona C Cuthbertson, Peter M RothwellAbstract:Background and Purpose—Face-to-face Cognitive testing is not always possible in large studies. Therefore, we assessed the telephone Montreal Cognitive Assessment (T-MoCA: MoCA items not requiring p...
Peter M Rothwell - One of the best experts on this subject based on the ideXlab platform.
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validation of the Montreal Cognitive Assessment versus mini mental state examination against hypertension and hypertensive arteriopathy after transient ischemic attack or minor stroke
Stroke, 2014Co-Authors: Alastair J S Webb, Sarah T Pendlebury, Z Mehta, Michela Simoni, Nicola Lovett, Peter M RothwellAbstract:Background and Purpose—Lack of reduced Cognitive impairment with blood pressure (BP) lowering in trials may reflect use of the Mini-Mental State Examination (MMSE), which is insensitive to mild Cognitive impairment after cerebrovascular events compared with the Montreal Cognitive Assessment. We determined relationships between impairment on MMSE versus Montreal Cognitive Assessment (MoCA) with the major physiological determinant of vascular Cognitive impairment: hypertension and hypertensive arteriopathy. Methods—Cognitive impairment in consecutive patients 6 months after transient ischemic attack or minor stroke was defined as significant, mild, or none (MMSE<23, 23–26, ≥27; MoCA<20, 20–24, ≥25) and related to 20 premorbid systolic BP readings, home BP measurement (3 measurements, 3×daily for 1 month), and hypertensive arteriopathy (creatinine, stroke versus transient ischemic attack, leukoaraiosis) by ordinal regression. Results—Of 463 patients, 45% versus 28% had at least mild Cognitive impairment on t...
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telephone Assessment of cognition after transient ischemic attack and stroke modified telephone interview of Cognitive status and telephone Montreal Cognitive Assessment versus face to face Montreal Cognitive Assessment and neuropsychological battery
Stroke, 2013Co-Authors: Sarah T Pendlebury, Sarah J V Welch, Jose Mariz, Z Mehta, Fiona C Cuthbertson, Peter M RothwellAbstract:Background and Purpose—Face-to-face Cognitive testing is not always possible in large studies. Therefore, we assessed the telephone Montreal Cognitive Assessment (T-MoCA: MoCA items not requiring pencil and paper or visual stimulus) and the modified Telephone Interview of Cognitive Status (TICSm) against face-to-face Cognitive tests in patients with transient ischemic attack (TIA) or stroke. Methods—In a population-based study, consecutive community-dwelling patients underwent the MoCA and neuropsychological battery >1 year after TIA or stroke, followed by T-MoCA (22 points) and TICSm (39 points) at least 1 month later. Mild Cognitive impairment (MCI) was diagnosed using modified Petersen criteria and the area under the receiver-operating characteristic curve (AUC) determined for T-MoCA and TICSm. Results—Ninety-one nondemented subjects completed neuropsychological testing (mean±SD age, 72.9±11.6 years; 54 males; stroke 49%) and 73 had telephone follow-up. MoCA subtest scores for repetition, abstraction, ...
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telephone Assessment of cognition after transient ischemic attack and stroke modified telephone interview of Cognitive status and telephone Montreal Cognitive Assessment versus face to face Montreal Cognitive Assessment and neuropsychological battery
Stroke, 2013Co-Authors: Sarah T Pendlebury, Sarah J V Welch, Jose Mariz, Z Mehta, Fiona C Cuthbertson, Peter M RothwellAbstract:Background and Purpose—Face-to-face Cognitive testing is not always possible in large studies. Therefore, we assessed the telephone Montreal Cognitive Assessment (T-MoCA: MoCA items not requiring p...
Isabel Santana - One of the best experts on this subject based on the ideXlab platform.
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Montreal Cognitive Assessment validation study for mild Cognitive impairment and alzheimer disease
Alzheimer Disease & Associated Disorders, 2013Co-Authors: Sandra Freitas, Mario R Simoes, Lara Alves, Isabel SantanaAbstract:The Montreal Cognitive Assessment (MoCA) was recently proposed as a Cognitive screening test for milder forms of Cognitive impairment, having surpassed the well-known limitations of the Mini-Mental State Examination (MMSE). This study aims to validate the MoCA for screening Mild Cognitive Impairment (MCI) and Alzheimer disease (AD) through an analysis of diagnostic accuracy and the proposal of cut-offs. Patients were classified into 2 clinical groups according to standard criteria: MCI (n=90) and AD (n=90). The 2 control groups (C-MCI: n=90; C-AD: n=90) consisted of Cognitively healthy community dwellers selected to match patients in sex, age, and education. The MoCA showed consistently superior psychometric properties compared with the MMSE, and higher diagnostic accuracy to discriminate between MCI (area under the curve=0.856; 95% confidence interval, 0.796-0.904) and AD patients (area under the curve=0.980; 95% confidence interval, 0.947-0.995). At an optimal cut-off of below 22 for MCI and below 17 for AD, the MoCA achieved significantly superior values in comparison with MMSE for sensitivity, specificity, positive predictive value, negative predictive value, and classification accuracy. Furthermore, the MoCA revealed higher sensitivity to Cognitive decline in longitudinal monitoring. This study provides robust evidence that the MoCA is a better Cognitive tool than the widely used MMSE for the screening and monitoring of MCI and AD in clinical settings.
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Montreal Cognitive Assessment moca validation study for vascular dementia
Journal of The International Neuropsychological Society, 2012Co-Authors: Sandra Freitas, Mario R Simoes, Lara Alves, Margarida Vicente, Isabel SantanaAbstract:The Montreal Cognitive Assessment (MoCA) is a brief instrument developed for the screening of milder forms of Cognitive impairment, having surpassed the well-known limitations of the MMSE. The aim of the present study was to validate the MoCA as well as its short version, which was proposed by the NINDS-CSN VCI Harmonization Standards for screening Vascular Dementia (VaD) patients. The results, based on a homogeneous sample of 34 VaD patients, indicate that the MoCA is a psychometrically valid and reliable instrument for Cognitive screening in VaD patients, showing excellent discriminant validity. Both the full and short versions of the MoCA had excellent diagnostic accuracy in discriminating VaD patients, exhibiting an area under curve (AUC) higher than the MMSE [AUC(MoCA full version) = .950; 95% IC = .868–.988; AUC(MoCA short version) = .936; 95% IC = .849–.981; AUC(MMSE) = .860; 95% IC = .754–.932]. With a cutoff below 17 on the MoCA full version and 8 on the short version, the results for sensitivity, specificity, positive and negative predictive values, and classification accuracy were superior compared to the MMSE. In conclusion, both versions of the MoCA are valid, reliable, sensitive and accurate screening instruments for VaD patients. ( JINS , 2012, 18 , 1–10)
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Montreal Cognitive Assessment moca validation study for frontotemporal dementia
Journal of Geriatric Psychiatry and Neurology, 2012Co-Authors: Sandra Freitas, Mario R Simoes, Lara Alves, Diana Duro, Isabel SantanaAbstract:The Montreal Cognitive Assessment (MoCA) is a brief instrument developed for the screening of milder forms of Cognitive impairment, having surpassed the well-known limitations of the Mini-Mental State Examination (MMSE). The aim of the present study was to validate the MoCA as a Cognitive screening test for behavioral-variant frontotemporal dementia (bv-FTD) by examining its psychometric properties and diagnostic accuracy. Three matched subgroups of participants were considered: bv-FTD (n = 50), Alzheimer disease (n = 50), and a control group of healthy adults (n = 50). Compared with the MMSE, the MoCA demonstrated consistently superior psychometric properties and discriminant capacity, providing comprehensive information about the patients' Cognitive profiles. The diagnostic accuracy of MoCA for bv-FTD was extremely high (area under the curve AUC [MoCA] = 0.934, 95% confidence interval [CI] = 0.866-.974; AUC [MMSE] = 0.772, 95% CI = 0.677-0.850). With a cutoff below 17 points, the MoCA results for sensitivity, specificity, positive predictive value, negative predictive value, and classification accuracy were significantly superior to those of the MMSE. The MoCA is a sensitive and accurate instrument for screening the patients with bv-FTD and represents a better option than the MMSE.
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Montreal Cognitive Assessment influence of sociodemographic and health variables
Archives of Clinical Neuropsychology, 2012Co-Authors: Sandra Freitas, Mario R Simoes, Lara Alves, Isabel SantanaAbstract:The Montreal Cognitive Assessment (MoCA) is a brief Cognitive instrument for screening milder forms of Cognitive impairment. The present study aimed to analyze the influence of sociodemographic (age, gender, educational level, marital and employment status, geographic region, geographic localization, and residence area) and health variables (subjective memory complaints of the participant and evaluated by the informant, depressive symptoms, and family history of dementia) on the participants' performance on the MoCA. The investigation was carried out in a Portuguese community-based sample of 650 Cognitively healthy adults, who were representative of the distribution observed in the Portuguese population. Educational level and age significantly contributed to the prediction of the MoCA scores, explaining 49% of the variance. Regarding health variables, only the subjective memory complaints of the participant showed a small contribution (9%) to the variance on the MoCA scores. This study contributes a useful approach to understanding MoCA performance, stressing the great impact of education and age on scores.
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construct validity of the Montreal Cognitive Assessment moca
Journal of The International Neuropsychological Society, 2012Co-Authors: Sandra Freitas, Mario R Simoes, Lara Alves, Joao Maroco, Isabel SantanaAbstract:The Montreal Cognitive Assessment (MoCA) is a brief instrument developed for the screening of milder forms of Cognitive impairment. The present study aims to assess the construct related validity of the MoCA through the establishment of the factorial, convergent, and discriminant related validities, and the reliability of data. In a Portuguese sample of 830 participants, several models were tested using Confirmatory Factor Analysis. Although all tested models showed a good fit, the six-factor model based on the conceptual model proposed by the MoCA's authors showed a significantly better fit. The results allowed us to establish the factorial, convergent, and discriminant validity of this six-dimensional structure. An overall psychometric adequacy of the items, and a good reliability were also found. This study contributes to overcome an important gap in the construct related validity of this instrument. The present findings corroborate the six-dimensional structure of the MoCA and provide good evidence of the construct related validity. The MoCA has proved to be an appropriate measure for Cognitive screening taking into account different Cognitive domains, which will enable clinicians and researchers to use this test and its six latent dimensions to achieve a better understanding of the individuals' Cognitive profile.
Z Mehta - One of the best experts on this subject based on the ideXlab platform.
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validation of the Montreal Cognitive Assessment versus mini mental state examination against hypertension and hypertensive arteriopathy after transient ischemic attack or minor stroke
Stroke, 2014Co-Authors: Alastair J S Webb, Sarah T Pendlebury, Z Mehta, Michela Simoni, Nicola Lovett, Peter M RothwellAbstract:Background and Purpose—Lack of reduced Cognitive impairment with blood pressure (BP) lowering in trials may reflect use of the Mini-Mental State Examination (MMSE), which is insensitive to mild Cognitive impairment after cerebrovascular events compared with the Montreal Cognitive Assessment. We determined relationships between impairment on MMSE versus Montreal Cognitive Assessment (MoCA) with the major physiological determinant of vascular Cognitive impairment: hypertension and hypertensive arteriopathy. Methods—Cognitive impairment in consecutive patients 6 months after transient ischemic attack or minor stroke was defined as significant, mild, or none (MMSE<23, 23–26, ≥27; MoCA<20, 20–24, ≥25) and related to 20 premorbid systolic BP readings, home BP measurement (3 measurements, 3×daily for 1 month), and hypertensive arteriopathy (creatinine, stroke versus transient ischemic attack, leukoaraiosis) by ordinal regression. Results—Of 463 patients, 45% versus 28% had at least mild Cognitive impairment on t...
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telephone Assessment of cognition after transient ischemic attack and stroke modified telephone interview of Cognitive status and telephone Montreal Cognitive Assessment versus face to face Montreal Cognitive Assessment and neuropsychological battery
Stroke, 2013Co-Authors: Sarah T Pendlebury, Sarah J V Welch, Jose Mariz, Z Mehta, Fiona C Cuthbertson, Peter M RothwellAbstract:Background and Purpose—Face-to-face Cognitive testing is not always possible in large studies. Therefore, we assessed the telephone Montreal Cognitive Assessment (T-MoCA: MoCA items not requiring pencil and paper or visual stimulus) and the modified Telephone Interview of Cognitive Status (TICSm) against face-to-face Cognitive tests in patients with transient ischemic attack (TIA) or stroke. Methods—In a population-based study, consecutive community-dwelling patients underwent the MoCA and neuropsychological battery >1 year after TIA or stroke, followed by T-MoCA (22 points) and TICSm (39 points) at least 1 month later. Mild Cognitive impairment (MCI) was diagnosed using modified Petersen criteria and the area under the receiver-operating characteristic curve (AUC) determined for T-MoCA and TICSm. Results—Ninety-one nondemented subjects completed neuropsychological testing (mean±SD age, 72.9±11.6 years; 54 males; stroke 49%) and 73 had telephone follow-up. MoCA subtest scores for repetition, abstraction, ...
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telephone Assessment of cognition after transient ischemic attack and stroke modified telephone interview of Cognitive status and telephone Montreal Cognitive Assessment versus face to face Montreal Cognitive Assessment and neuropsychological battery
Stroke, 2013Co-Authors: Sarah T Pendlebury, Sarah J V Welch, Jose Mariz, Z Mehta, Fiona C Cuthbertson, Peter M RothwellAbstract:Background and Purpose—Face-to-face Cognitive testing is not always possible in large studies. Therefore, we assessed the telephone Montreal Cognitive Assessment (T-MoCA: MoCA items not requiring p...
Howard Chertkow - One of the best experts on this subject based on the ideXlab platform.
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evaluation of a telephone version for the Montreal Cognitive Assessment establishing a cutoff for normative data from a cross sectional study
Journal of Geriatric Psychiatry and Neurology, 2021Co-Authors: Sivan Klildrori, Natalie A Phillips, Alita Fernandez, Shelley Solomon, Adi J Klildrori, Howard ChertkowAbstract:Objective:Compare a telephone version and full version of the Montreal Cognitive Assessment (MoCA).Methods:Cross-sectional analysis of a prospective study. A 20-point telephone version of MoCA (Tel...
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Montreal Cognitive Assessment moca concept and clinical review
2013Co-Authors: Parunyou Julayanont, Natalie A Phillips, Howard Chertkow, Ziad S NasreddineAbstract:The Montreal Cognitive Assessment (MoCA) is a Cognitive screening instrument developed to detect mild Cognitive impairment (MCI). It is a simple 10 min paper and pencil test that assesses multiple Cognitive domains including memory, language, executive functions, visuospatial skills, calculation, abstraction, attention, concentration, and orientation. Its validity has been established to detect mild Cognitive impairment in patients with Alzheimer’s disease and other pathologies in Cognitively impaired subjects who scored in the normal range on the MMSE. MoCA’s sensitivity and specificity to detect subjects with MCI due to Alzheimer’s disease and distinguish them from healthy controls are excellent. MoCA is also sensitive to detect Cognitive impairment in cerebrovascular disease and Parkinson’s disease, Huntington’s disease, brain tumors, systemic lupus erythematosus, substance use disorders, idiopathic rapid eye movement sleep behavior disorder, obstructive sleep apnea, risk of falling, rehabilitation outcome, epilepsy, chronic obstructive pulmonary disease and human immunodeficiency virus infection. There are several features in MoCA’s design that likely explain its superior sensitivity for detecting MCI. MoCA’s memory testing involves more words, fewer learning trials, and a longer delay before recall than the MMSE. Executive functions, higher-level language abilities, and complex visuospatial processing can also be mildly impaired in MCI participants of various etiologies and are assessed by the MoCA with more numerous and demanding tasks than the MMSE. MoCA was developed in a memory clinic setting and normed in a highly educated population. A new version of the MoCA called MoCA-Basic (MoCA-B) was developed to fulfill the limitation of the MoCA among the low educated and illiterate population. MoCA Memory Index Score is a newly devised score that can help clinicians better predict which patients with MCI are most likely to convert to dementia. The MoCA is freely accessible for clinical and educational purposes (www.mocatest.org), and is available in 56 languages and dialects.
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normative data for the Montreal Cognitive Assessment moca in a population based sampleauthor response
Neurology, 2012Co-Authors: Ziad S Nasreddine, Heidi Rossetti, Natalie A Phillips, Howard Chertkow, Laura H Lacritz, Munro Cullum, Myron F WeinerAbstract:# {#article-title-2} Rossetti et al.1 reported a population-based study of scores on the Montreal Cognitive Assessment (MoCA) in Texas. Compared to our study2 in Montreal, the Caucasian group of normal controls in the Rossetti et al. study was considerably younger (52.9 vs 72.8 years) and had slightly lower mean MoCA scores (25.6 vs 26.9). In the other ethnic groups, they found substantial effects of age and education on their MoCA scores. Subjects in our study were excluded if they had subjective complaints …
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sensitivity and specificity of the Montreal Cognitive Assessment modified for individuals who are visually impaired
Journal of Visual Impairment & Blindness, 2010Co-Authors: Walter Wittich, Natalie A Phillips, Ziad S Nasreddine, Howard ChertkowAbstract:Evaluating the Cognitive status of individuals who are visually im- paired is limited by the design of the test that is used. This article presents data on the sensitivity and specificity of the version of the Montreal Cognitive Assessment for people who are visually impaired. The original validation data were reanalyzed, excluding the five visual items. The results indicated that the specificity was excellent, while sensitivity was reduced; however, the recom- mended proportionally adjusted cutoff values showed better sensitivity.
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the Montreal Cognitive Assessment moca a brief screening tool for mild Cognitive impairment
Journal of the American Geriatrics Society, 2005Co-Authors: Ziad S Nasreddine, Jeffrey L. Cummings, Natalie A Phillips, Valerie Ediria, Simo Charbonneau, Victo Whitehead, Isabelle Colli, Howard ChertkowAbstract:Objectives: To develop a 10-minute Cognitive screening tool (Montreal Cognitive Assessment, MoCA) to assist first-line physicians in detection of mild Cognitive impairment (MCI), a clinical state that often progresses to dementia. Design: Validation study. Setting: A community clinic and an academic center. Participants: Ninety-four patients meeting MCI clinical criteria supported by psychometric measures, 93 patients with mild Alzheimer's disease (AD) (Mini-Mental State Examination (MMSE) score≥17), and 90 healthy elderly controls (NC). Measurements: The MoCA and MMSE were administered to all participants, and sensitivity and specificity of both measures were assessed for detection of MCI and mild AD. Results: Using a cutoff score 26, the MMSE had a sensitivity of 18% to detect MCI, whereas the MoCA detected 90% of MCI subjects. In the mild AD group, the MMSE had a sensitivity of 78%, whereas the MoCA detected 100%. Specificity was excellent for both MMSE and MoCA (100% and 87%, respectively). Conclusion: MCI as an entity is evolving and somewhat controversial. The MoCA is a brief Cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in patients performing in the normal range on the MMSE.
